Social Determinants of Health Among Individuals Receiving Opioids for Pain Management

Individuals receiving opioids for pain management are at risk for negative outcomes. However, it is not clear whether social determinants of health (SDOH) predict outcomes a year after starting a prescription opioid. The purpose was to examine associations between SDOH with psychiatric-related, pain-related, and opioid-related outcomes at a 12-month follow-up.

Participants (N=783) with a new period of 30 to 90-day opioid use completed baseline and 12-month follow-up questionnaires regarding SDOH, depressive symptoms, pain severity, pain interference, and opioid use. Multivariate adjusted models estimated the association between SDOH and outcomes.

Participants had a mean age of 53.4 years (SD=11.9), 71.2% White race, and 69.9% women. Older age (OR=0.97; 0.95, 0.99) and Black race (OR=0.45; 0.27, 0.76) were inversely associated with depression, while being widowed/divorced/separated (OR=1.72; 1.01, 2.91) and lacking a college education (OR=2.43; 1.25, 4.73) were positively associated with depression. Women (OR=1.56; 1.12, 2.18) and lower income (OR=2.09; 1.14, 3.85) were associated with greater odds of opioid use, while unemployment was associated with lower odds of opioid use at 12 months (OR=0.55; 0.34, 0.89). Older age (OR=0.95; 0.91, 0.99) was inversely associated with opioid use concerns while disability (OR=4.59; 1.60, 13.11) was positively associated.

Several SDOH variables were associated with poorer functioning at baseline and 12 months after individuals were prescribed an opioid. It may be useful for clinicians to screen for SDOH to identify higher-risk individuals.